BOOK REVIEWS: The Prevention of Eating Problems and Eating Disorders: Theory, Research and Practice
Reprinted from Eating Disorders Review
July/August 2006 Volume 17, Number 4
©2006 Gürze Books
This is the best book on the prevention of eating problems and eating disorders I've seen in a long while. It's particularly notable because rather than offering up the usual compilation of edited chapters, this volume was completely written by two scholars who know the field cold. The authors are steeped in all aspects of the prevention story–values, controversies, successful and unsuccessful attempts, strengths, weaknesses, and opportunities. They discuss these issues clearly and objectively, with little redundancy, in a smoothly coherent writing style.
To start with Part I, after an excellent introduction and overview of the field of prevention, the authors turn to defining eating problems and disorders. In Part II, they review key concepts in developmental psychopathology, and then discuss what is known about risk factors for these disorders. I found their subsequent chapters, describing psychosocial influences in eating disorders from the perspectives of social cognitive approaches, nonspecific stressor-vulnerability models, and feminist empowerment, to be particularly interesting.
Part III centers around the prevention research literature. The key chapter here systematically lays out the evidence in text and tables, showing its insights and gaps. It covers studies conducted at the elementary, middle school and high school levels, and with older adolescents and young adults, including programs with healthy populations, as well as those targeted to populations already demonstrating subclinical levels of distress.
The authors address the relative merits and problems of prevention programs aimed at the "universal" population at large, where a few exposed individuals with disturbed body attitudes and eating may actually get worse. They then compare these programs with prevention programs specifically targeted to subpopulations that seem particularly at risk of eating disorders. They conclude that better programs addressing both populations are needed.
Lessons from the field are the focus of Part IV, starting with suggestions for curriculum and program development derived from substance abuse prevention work in early adolescents. Six excellent "lessons" are presented and discussed with respect to how they might apply to eating disorders. These school- and community-based programs offer specific ecologically sensitive suggestions aimed at several developmental levels from elementary school through college and young adulthood. These suggestions also apply to boys and racial and ethnic minority populations, and address the significant problems presented by obesity as well as conventional eating disorders.
Practical guidance follows on how to deliver and evaluate these programs, efforts on changing the ecology, and using media and media literacy instruction. The book concludes with chapters that can help local and grassroots preventionists decide exactly what audience they should target and how to go about their efforts. This section also lays out necessary future research directions.
As an added bonus, several excellent appendices offer sources for educators, clinicians, researchers and parents, and, unique to my knowledge, offer additional resources for those interested in advocacy and community activism. Accordingly, as expensive as it is, this book should appeal to a wide audience of those concerned with preventing disturbed eating and eating disorders at the school, community and political levels.